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sgcouk
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Not making money - Help Empty Not making money - Help

on Fri Jun 21, 2019 9:19 pm
So before the update, I had this down to a fine art. I had a hospital design, I systematically worked through the departments in the order the game suggests to you and by the time I come to open the last department, I'm making loads of money. Since the update however, this no longer works. If I try to do the things as suggested in the Insurance Objectives order as soon as I open the Hospitalization at specialist department, I rapidly start losing money. If I open all 6 clinics I make money, as soon as I open Hospitalization at a specialist department, I start losing money. No matter how I try to play the game, what new ways I come up with, it's always the same. As soon as I open Hospitalization, my funds drain so fast. I end up negative 80K and taking out loans just makes things worse.

Is this just me? Has anyone else noticed a shift since the update that makes succeeding an incredible challenge?

To the game makers... What changed? How is a hospital now supposed to make money? I've played this game virtually every day since the update and no matter what new tactic I employ it's always the same result. Where am I going wrong? What new mechanic has been added that I don't understand?


I'm beginning to feel negatively about this game and I really don't want to because I love it, but when no matter what I do I can't get to having a full hospital, the game gets less fun to play. People of Oxymoron, please help me figure it out and enjoy this game again.
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MedJet
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Not making money - Help Empty Re: Not making money - Help

on Sat Jun 22, 2019 4:56 am
Ironically, after playing the game for quite a while under version 1.0, I was having some of the same thoughts you mentioned. I started out with an entirely new hospital. Determined to limit the amount of money I borrowed and limited grant money usage (which makes the game very challenging and slow) I set out to build. Here are some of my observations. If you don't have a steady number of patients for hospitalization it's very easy to go in the red with all the additional overhead it requires. I found myself headed on the road to never-ending negative balances when I expanded hospitalization too fast. After starting over with a new hospital I decided to concentrate on developing profitable clinic departments first. Completing the insurance challenges increases daily patient count. Once I had a robust foundation I opened a general surg dept. started off with 2 beds then added a few. Now I've got 10 and have smaller hospitalization depts for neuro and ortho. Not too big 4-6 beds, largely profitable and I setup my general surg dept to parallel these so I can assign overflow patients (ortho and neuro) into general beds when needed. I saw another player mention dedicated surgery teams. I implemented this and find it streamlines patient flow. Building your ambulance traffic is key too. I make quite a bit of money off of the emergency cases arriving via medic unit. Now, I have noticed some definite variation in profitability from day-to-day. Some days are lean in hospitalization, other days really flush. I find that steady clinic traffic can act as a buffer. Also, prestige plays a noticeable role. I-for the most part- am able to maintain five stars , thus the bonus income and patient traffic. However, when I opened new areas and depts I've found that dirty floors can easily take this away and the resultant decrease really hurts the bottom line.

Lastly, follow the flow of money via your money screen. If areas are repeatedly in the red, scale back until they reach profitability. It's doable. Most days I profit 6-8k, some days 10-18k or more. I have been able to invest steadily in another ICU bed as well as significant hospital expansion now and to come.

regards.
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MedJet
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Not making money - Help Empty Re: Not making money - Help

on Sun Jun 23, 2019 4:33 am
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p.s. I've never liked the way they have implemented prestige in this game. For it to arbitrarily just drop at the turn of the shift is ridiculous. As long as your floors are fairly clean and the amenities needed are provided it shouldn't drop as it does. Course my guess is they (the developers) might comeback with something like "it models real world employee attitude about coming to work." Hence the sometimes strange logic behind a few features in this game.

**ran some more checks. Yes, there is definitely a negative satisfaction skew on janitors. Once again, I go back to some of the questionable logic they're employing in a few areas of this game. The other being endless stat lab testing when there is a 100% unconfirmed diagnosis for a patient and the level of dept confirmation is set to "low."
quirkycat
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Not making money - Help Empty Re: Not making money - Help

on Thu Jul 18, 2019 11:32 am
Start small, one or two beds in each hospitalisation. Only add beds as needed.
Make sure your surgery is working, this is where the big money is. It takes three doctors and two nurses, plus another nurse to move the patient to theatre. If one of them is busy then no operation can take place. A surplus of doctors and nurses can help here. Also having a night-time surgical team can help if you have a queue of patients.
Keep prestige high for the bonus; make sure every room has a decoration. If staff are bored put a radio in the room - I have found this helps particularly in Radiology and Labs. Don't hire staff that have negative stats; these can ruin your prestige. Make sure all departments are getting the Good Boss bonus.
Open night-shifts early; if you don't day-patients get sent home and you lose the potential income.

Also note that it is cheaper to build new floors than make the ground floor bigger. I usually increase max floors to eight or nine and most departments get their own floor.

Hope some of that helps.
Memnon
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Not making money - Help Empty Re: Not making money - Help

on Sat Aug 10, 2019 1:07 am
I  have same problems.Make  more  money with  just  reception and  3  doctors  than  with  3 full functional  department.Hospitalization and operation  is  a little  bit  too cheap.
With 3 doctors and im make 8  k  per day.When im open all 9 full operation department day/night im lose between 6-10 k  per day.Im  hope soon we get  a small  patch with  just  a little bit  increase price.
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MedJet
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on Mon Sep 09, 2019 8:45 pm
Memnon wrote:I  have same problems.Make  more  money with  just  reception and  3  doctors  than  with  3 full functional  department.Hospitalization and operation  is  a little  bit  too cheap.
With 3 doctors and im make 8  k  per day.When im open all 9 full operation department day/night im lose between 6-10 k  per day.Im  hope soon we get  a small  patch with  just  a little bit  increase price.

I can attest that it's possible to have a fairly lucrative hospital operation w/ all departments. Focus on opening up capacity of insurances that pay better and slowly begin hospitalization while tracking areas of profit and loss.
DocDesastro
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Not making money - Help Empty Re: Not making money - Help

on Mon Sep 09, 2019 11:00 pm
Maybe this is just the point. Getting there is unintuitive. When I open a department I expect it to make revenues. But besides the clinic and the operating theater they do not. To get there means to invest into dead horses for midgame just to unlock a better insurance and neglect poorer patients just for profit optimization? I did not know the game was that dark. While my doctors gain XP and level and I might need to fire them because they will cost me too much money?! I just do not get what I am doing wrong here, but in my book running a hospital is about healing patients and making money with assets I buy. What is the break-even point?! Everything is fine unless I need to build hospitalization. To get the tier 4 insurance I need to buy 3 ambulances which requires me to build a hospitalization department which puts me into financial deadlock as it does not generate revenues but only losses and eats up all I generate in revenues. I cannot charge a patient to occupy a bed in the ward, I cannot charge resuscitation after a collapse, I cannot charge ICU time, I cannot charge treatments, I cannot charge lab exams - but the game is trolling me with having more and more of them. Meanwhile, my staff will become more expensive because they get better. The game starts promising and generated a big smile on my face unless I was deadlocked in every single attempt. This might have something to do with the fact that
a) I believe in quid pro quo - I have to pay for a thing a doctor does to me
b) I get to see real doctor's bills and know exactly what they charge me for..and yes, this is EVERY single tiny bit they do. Exams, lab, even the post stamps and envelope the bill was in. Even phoning them to make an appointment on my initiative is enough to bill me 10€ just for counseling - even if I only talked to a nurse and not even the doctor. So I see building a department as an opportunity to make money as I am able to cure more diseases after doing so but also have more workers generating revenue. Because everything my doctors and techs do is work and work is ought to be paid for. But no, only the doctor's offices do generate money and it is a flat sum per disease no matter how much effort was placed into treating it. In reality it does not matter which disease you have. The bill consists of things done to you being it a palpation, diet counseling, getting some ointment or have a full surgery with ICU care. Yes, the bill has a diagnosis written on it, but I pay for the work the doc and associated labs have done. Soo...maybe I expect too much reality from a game that looks a lot more real and plausible than Two Point Hospital. Maybe I should have watched more lets plays first before buying.

I cannot say that I am happy with things standing as they are. I am quite disappointed instead because I do not know how to evade the financial deadlock that should not have been in the game from start design-wise. And even if I did, I would guess the solution would be non-intuitive and not fun. The game should reward me for making right decisions - and this ought to be expanding from clinic to something greater and building a hospital that is profitable but also intuitive to build. Building a hospitalization department throws me into financial limbo instead of putting me into another league. I am still stuck with 50 patients and a payroll that eats up everything I make per day although I try to minimize personal. Just enough to cope with patient flood, but no - once I have doctors and nurses in on-call rooms things get ugly. That certainly is not working as intended, is it?

Please excuse myself being passionate about it but I see a marvelous jewel in the game and yet...it is not working - for me...and for the time being. Sorry.
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MedJet
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on Mon Sep 09, 2019 11:52 pm
Yeah, I suspect as you state that your beliefs about how the game should be designed/performing especially in the area of billing and revenue generation conflict with your own personal beliefs on such. The behaviors of some staff (and the responses given by devs for such bother me). It is possible to generate a fairly consistent -- albeit fluctuating -- revenue across departments to the point one can continue to make meaningful investments in their hospital. I enclosed a sample snapshot from one of my days. My hospital is neither small nor large. Perhaps in the future the game may work better for you. Also, what do you mean by "operating theatre"? One might also be able to argue that by unlocking the more lucrative insurance cases one can choose to treat more uninsured/under-insured "poor" cases.  No doubt the billing system in game is not perfect, heck, I have stumbled along the way to hospitalization across all depts, as the game is definitely very unintuitive in some areas. regards.Not making money - Help Buget10
DocDesastro
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Not making money - Help Empty Re: Not making money - Help

on Tue Sep 10, 2019 6:50 pm
Well, beliefs are a bit wrong to describe it...I actually tell you what you are expected to pay a doctor when you visit a clinic - in Germany at least. Those insured will not see these bills as the insurance company gets them directly and need not to worry - that is where they pay their 15% of their income for. But when you get a bill you will clearly see that almost everything is charged for...even depending on how difficult or tedious it was with a multiplicator where x2.3 is standard. I guess they did this in order to counter inflation but the point is: in reality a lab sends you a bill, the radiologist does, the pharmacy gets to be paid, the hospital for hospitalization, the departments for surgeries and diags...they all sum up. It is never the case that you have to pay a flat 70$ for the common cold. It also never is the case that insurance companies decide how many patients you will get, and when. People just go to the nearest doctor (resitential density) or...if they know a good one they choose one over the other (prestige!). Some seasons cause more illnesses than others like flu in winter as people stay together out of the cold and transmitting diseases is easier. At night your ambulances might get more cases of injuries after brawling or alcoholic poisonings. In summer, people might get back from exotic countries (holidays) and could bring some strange diseases with them. I still try to find out how realistic the game wants to be. In terms of diseases, treatment and diagnoses it is fairly realistic. In case of patients visiting or writing bills it is not at all. In every hospital, patients will have a balance and each department will in-debt it for their services. They will "will bill you or your insurance carrier for non-physician or facility charges such as room and board, nursing services, laboratory services and medical supplies." or "for any services you receive from physicians." The latter two quotes are directly from UK healthcare to show that Germany is not alone with that. I think, this will almost be like this anywhere in the world so we might think about how much of that realism we want to pack into the game. It is more intuitive to have a ward and pay wages for your nurses and on-call doctors if you also get money for patients using said beds and receiving medicine, diagnoses or visits from the doc instead of juggling with patient numbers and payment multipliers from the insurance companies to even out revenue-generating departments like doctor's offices and non-profit ones like wards, labs or ICUs.
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MedJet
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Not making money - Help Empty Re: Not making money - Help

on Tue Sep 10, 2019 9:42 pm
DocDesastro wrote:Well, beliefs are a bit wrong to describe it...I actually tell you what you are expected to pay a doctor when you visit a clinic - in Germany at least. Those insured will not see these bills as the insurance company gets them directly and need not to worry - that is where they pay their 15% of their income for. But when you get a bill you will clearly see that almost everything is charged for...even depending on how difficult or tedious it was with a multiplicator where x2.3 is standard. I guess they did this in order to counter inflation but the point is: in reality a lab sends you a bill, the radiologist does, the pharmacy gets to be paid, the hospital for hospitalization, the departments for surgeries and diags...they all sum up. It is never the case that you have to pay a flat 70$ for the common cold. It also never is the case that insurance companies decide how many patients you will get, and when. People just go to the nearest doctor (resitential density) or...if they know a good one they choose one over the other (prestige!). Some seasons cause more illnesses than others like flu in winter as people stay together out of the cold and transmitting diseases is easier. At night your ambulances might get more cases of injuries after brawling or alcoholic poisonings. In summer, people might get back from exotic countries (holidays) and could bring some strange diseases with them. I still try to find out how realistic the game wants to be. In terms of diseases, treatment and diagnoses it is fairly realistic. In case of patients visiting or writing bills it is not at all. In every hospital, patients will have a balance and each department will in-debt it for their services. They will "will bill you or your insurance carrier for non-physician or facility charges such as room and board, nursing services, laboratory services and medical supplies." or "for any services you receive from physicians." The latter two quotes are directly from UK healthcare to show that Germany is not alone with that. I think, this will almost be like this anywhere in the world so we might think about how much of that realism we want to pack into the game. It is more intuitive to have a ward and pay wages for your nurses and on-call doctors if you also get money for patients using said beds and receiving medicine, diagnoses or visits from the doc instead of juggling with patient numbers and payment multipliers from the insurance companies to even out revenue-generating departments like doctor's offices and non-profit ones like wards, labs or ICUs.

Rolling Eyes  See: GAME.
DocDesastro
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on Tue Sep 10, 2019 11:10 pm
Yep. a game that marvelously covers the medical aspect and just fails badly in terms of depicting an intuitive revenue system (making it a BAD game in that special regard while it is superb at the others). Back to topic, because I have the same question: How to make money after you have reached the 50 patients mark? Usually you would have a blood lab, an X-Ray, one trauma center, a ward - all with minimum personal. Add in one specialized office like general surgery. 4 to 5 GPs with one or two at night shift to cope with patient intake. The first three insurance companies active. Then what? Game says: build a hospitalization, buy 1 or 3 ambulances to proceed. The latter are hard-locked because of lacking hospitalization. Once I open it however: financial deadlock. Or am I supposed to skip 20 days in-game to have 500k to do everything at once? What is the key to success? Having the labs, wards, X-rays and ICUs not contributing to hospital upkeep is simply not intuitive and not logical. So: what to do better than that? How to do it right? Currently my games end in frustration. Maybe the OP's games as well. Working as intended? Showing a budget that states it can be profitable but not how you did that is not helpful.
Dr Tats
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on Fri Nov 01, 2019 4:58 pm
Hi there !

A little bit late, I hope you didn't abandon the game yet, but I have little hope...

However, my Hospital is actually working with the 9 departments working (not fully though, waiting for my first patient requiring hospitalization to hire neuro surgeon and everything, but I am full of money), making more or less 50k/day and without any single loan !
So basically... patience is the key, specially between the opening of the clinic and opening the hospitalization, then it goes quite quickly.

When you start hospitalization, difficult cases will be coming in ALL departments, even if you have hospitalization opened in only one department, so you have to be ready, but you don't have to do all in once though.

My step by step technique in broken English :

-Think about the logistic of your hospital, so you don't have to destoy and redo part of it, you can move rooms now but it still cost small money. Playing all the campaign helps a lot to get the best logistic to be productive with lower cost (even if of course you should not try to imitate the fancy "a fully furnished room for everyone" in intensive care for instance). You can use the "maping" system to make a big map of your first floor before starting to build

-Be Spartan, whatever if half of the walls are lacking at first, nobody doesn't cares as soon as there is a plant, a vending machine and a poster somewhere near

-Open your night clinic as soon as there is a patient left at 18:00, let's take care of EVERYBODY

-Help your doctors to make diagnosis and the right testings to increase productivity and reputation, do not add any room until all the other one are said as "CRITICAL" for more than 1 day.

-Put plants, posters everywhere, and water in each doctor's office to avoid them to walk away

-Easy tip but having a "good leader" managing each department helps a LOT keeping your reputation and employees motivation high (I have 110% per day)

-Be generous in toilets

-You don't have to build & open right away, when you have a nice amount of money, start building little by little, without opening anything too quickly, always keep at least 20k reserve for emergency

-Choose which department you will build next :
-Ortho is easy to handle, easy to make diagnostics quickly, and brings a fair amount of money, you can help doc for diagnosis when you lack a MRI (you're not close to have one) I like to build it first
-Surgery bring a lot of money ! But not so much before hospitalization begin, it's my number 2

-When I have these 2, I start building hospitalization department, I will open trauma/observation room only when all the 3 department hospitalization rooms are ready with at least 2 beds in each, then I will hire surgeon, nurses and everything to open the next hospitalization department only when my first patient requiring hospitalization in this department steps in, no need to pay all theses salaries if there is no one to treat.

-I hate observation room, I only have 1 bed there, I keep my doctors and nurses focused on trauma. They are very bored sometimes but whatever.

-I know it's hard but do not hurry to achieve insurance company requirements

Then you will see a looooong step of difficulties, when you have to add beds or rooms but you can't because you're broke. You can use imagination by moving beds from one room to another, having 1 radiologist for 2 rooms and switching them manually (only works at night when you get busy) etc. Do not use pre-designed room because they have a lot of unuseful material and doing it manually is much more economical. You can copy your own rooms of make your own cheap predesigned rooms.
Then, each department you will open will need to have hospitalization ready to open, because complicated cases will usually come on day 2 or 3 if not before. Usually I open Cardiology (love it, bring lot of money but hospitalization and complication rates are very high, so you come to panic a lot when you open it, and soon needs more angio and echos), then neurology, then Internal medicine (cheeeeap).

Then, you should be as rich as I am !

I am quite happy that the game is now more difficult, because I am a simulation game addict but I get bored quickly if it's too easy. Since this summer's update I stated to play soooo much ! But now I got it so...starting to get easy Sad
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